Hi. I am Cathy with Level Up RN. In this video, I am going to talk about
pancreatitis. If you have our Level Up RN medical-surgical nursing flashcards,
definitely pull those out. And make sure you review the bold red text on these cards
because there are several very important points you need to know about pancreatitis.
At the end of the video, I'm going to give you guys a little quiz to test your knowledge
of some of the key points I'll be covering in this video, so definitely stay tuned for that.
Pancreatitis is inflammation of the pancreas. So any time you see -itis, that means inflammation,
so inflammation of the pancreas. So normally, the pancreas sends inactivated enzymes
to the small intestine, where they become activated and they help to digest fat, protein,
and carbs. With pancreatitis, those enzymes become prematurely activated,
such that they end up auto-digesting the pancreas, and that results in fibrosis of the pancreas.
So risk factors associated with pancreatitis include alcohol abuse, which is a really
important key factor. Other risk factors can include bile tract disease, GI surgery,
gallstones, trauma, as well as medication toxicity. Signs and symptoms can include
severe, left upper quadrant, or epigastric pain, and there will be possible radiation
of this pain to the left shoulder or back. In addition, the patient will have nausea
and vomiting, and they'll have something called Cullen's sign, which is where we have blue-grey
discoloration around the umbilicus or the belly button. So I was trying to think of a good way to
help you guys remember Cullen's sign. One of my viewers said, "Hey, Edward Cullen from Twilight
has kind of a blue-grey discoloration to his complexion." And so I have to admit I've not
seen Twilight, but I did Google Edward Cullen, and he does kind of have a pale complexion,
might be a little blue or grey in discoloration. If that helps you to remember Cullen's sign,
then I am all for that. The other sign that may be present is Turner's sign, so we do have a
cool chicken hint here for Turner Sign. So if you turn your patient over on their side, you will see
Turner's sign, which is ecchymosis that will show up on the patient's flank.
Other signs and symptoms include jaundice as well as tetani, which is associated with hypocalcemia
that we often see with pancreatitis. Abnormal labs that are associated with
pancreatitis are very important to know. Labs that may be elevated include amylase, lipase,
white blood cells, bilirubin, as well as glucose. So why is glucose elevated? Well, the pancreas
normally makes insulin. So if the pancreas is messed up and not making enough insulin, then
that glucose is not getting from the bloodstream into the body's cells, and it's accumulating in
the bloodstream. Lab values that may be decreased include calcium, magnesium, and platelets. So in
terms of diagnosis, we can use an ultrasound, CT scan, or MRI to help diagnose pancreatitis. For
patient with pancreatitis, we're going to place them on NPO and then gradually have them consume
a bland and low-fat diet over time. In addition, we're going to provide IV fluids and electrolytes.
We're going to provide opioid analgesics because pancreatitis is associated with severe pain.
In addition, we need to provide antibiotics, antiemetics for nausea and vomiting,
insulin so that we can get that glucose into the body's cells, and then pancreatic enzymes with all
meals and snacks. Because again, the pancreas is messed up, so it's not doing its normal job, which
includes bringing those digestive enzymes over to the small intestine to help with digestion.
In terms of nursing care, we're going to want to monitor for complications,
which can include chronic pancreatitis, which is something we see often with alcohol abuse.
Other complications include a pancreatic pseudocyst.
So this is where we have these fluid-filled sacs that form kind of in or around the pancreas.
And then type 1 diabetes is also a complication of chronic pancreatitis.
In terms of patient teaching, we want to definitely emphasize that the patient should not
consume alcohol. And if appropriate, we should refer the patient to an alcohol recovery program.
And then we should encourage the patient to consume a low-fat diet, ongoing, and no smoking.
All right. Are you guys ready for your quiz? I have three questions for you. First question,
what do you call the ecchymosis on the flanks of a patient with pancreatitis?
The answer is Turner's sign. Question number two,
what do you call the blue-grey discoloration around the umbilicus with pancreatitis?
The answer is, Cullen's Sign. All right. For this third question, I want you to tell
me whether the lab value will be increased or decreased with pancreatitis. You ready? Glucose?
It will be increased. Amylase, increased. Calcium, decreased. Lipase,
increased. Magnesium, decreased. Okay. That's it for pancreatitis. I hope you learned a lot.
Take care and good luck with studying.
I invite you to subscribe to our channel and share a link with your classmates and
friends in nursing school. If you found value in this video, be sure and hit the like button,
and leave a comment and let us know what you found particularly helpful.